A family is outside, wishing their fourth grader bye as he gets on the school bus. It’s a crisp Midwest morning, the sun is shining and everything is rich in color and drenched in sunshine. The parents look tired and a little out of sorts while the kids have their backpacks and wonder in their eyes.

The crossing guard has arrived at this spot and parents are relieved to see the same guy from last year. A cheerful and chatty man who waves at everyone with lots of heart.

There is lunch in the backpack and carrots with the ranch dip. There are random conversations about weather and school that have nothing but superficial value.

There is transition and amazement in this day today.

The first day of school.

Families are expecting a return to the routine. The pools will close soon. Activities will start. Classes will begin.

As the bus pulls over, kids line up and there is sudden commotion. Goodbyes and hugs ensue. As kids get on the bus, it slowly drives away.

All moms get back home to finish their coffee and get settled.

One mom sobs profoundly. She cries and she wails in pain. Her husband holds her for as long as she cries. She wants her pain to turn into tears and leave her so she can also finish her coffee and pretend that it’s alright. She is successful in doing that most of the time. But today, she couldn’t.

She is unsure how many of these days she will have.

I don’t know either.

As they say, “Make memories”. I made some more today.

And stay hopeful that there will be another first day of school for this mom.

I have written a lot about cancer, treatments and the trauma that one has to deal with. But today I write about the Almighty “flu” … not real influenza but the routine upper respiratory infection. It’s an experience that is common to all of us and it is a miserable experience. We all know the sore throat, cold, aching sinuses and hacking cough. This may or may not be accompanied by a fever.

If cancer is the emperor of all maladies, upper respiratory infections are the queen. They make the feeling of misery very common. Everyone has experienced it at one point or the other. Queen grants much more appearances than the emperor does. I have met both.

It follows a typical pattern. You are having a good day and suddenly you just don’t feel so well. It’s hard to articulate what isn’t right but a feeling that you would love to lie down and rest. You don’t appear sick but internally feel that something is a bit off. Few hours later the throat feels like someone grabbed a sand paper and rubbed it nice. Pretty soon the eyes feel like they are a wee bit dry with a little burning feeling in them. And soon enough, all mucosal linings of the head and neck engage in a rebellion synchronized  where they are either secreting stuff or dry as heck . Gradually the burning feeling takes over and oops, there is the fever. Now the entire body is aching and you are sick. It feels like the end of the world but it’s really not and you know it but it certainly feels like there is no point carrying on. I get very depressed with colds. I find it funny that I run around with stage 4 cancer while on treatment or that I worked through my chemotherapies but a cold and 100.4 fever is what gets me miserably laid up.

And because of the cold the nasal septum hurts and feels sore. I can’t stand when the sinuses hurt. It’s a dull malicious pain in the forehead and the bones in the cheek as if your face is pressed into a hard surface. This package of misery at its peak usually lasts 1-2 days and you get surrounded by advice to drink lemon ginger tea and chicken soup. Amazingly hot liquids do help so much, so does a hot shower and a little TLC from the family.

And then you cough, a nasty hacking cough reminiscent of someone at the sanatorium. And with the cough, you feel your brain move and the sinuses that feel full get jostled and the head hurts some more.

And then slowly things get better. Albeit some of us, transition to a bacterial infection and need antibiotics.

We live in this world with many micro organisms and URIs are a gentle reminder that we share this space with others and must be respectful of those we co exist with. We are reminded the facts that size does not matter, the fact that life comes with interruptions and recovery. Its pause and go.

Pause for me. Cancer is treating me nicely for now, recent scan showed everything looked stable. But a little virus has gotten me to my knees.

But then, of course if I can get through 16 cycles of chemotherapy, I sure can get through this.

Here is to Chicken noodle soup and to friends who feel like such on hard days.

I have not written much lately. It may be a sign of my avoidance. Sometimes, writing and talking about cancer is also exhausting. Sometimes, it feels like reliving it and too much of a preoccupation. Cancer has weaved itself into my being and unwilling to abandon me much like the love and support of my friends and family.

And life is a complete package of good and the bad. I work on accepting both simultaneously as I hold on to some and let go of some.
I have been busy with the rest of my life. My family, kids and the new found freedom of not having patients to care for. I miss being a doctor very much but I also realize that being a doctor is not confined to the office. Healing is a 24/7 profession that is also incorporated in me as a person. I just don’t get paid in money for it but lots in kindness and gratitude which are the biggest gifts of all.

Recently I have been running into my patients too often on my trips to restaurants and store and wonder if it’s a sign for me to know that they are okay. We often think of ourselves as irreplaceable as people but time and time again, I have seen and experienced that we are all dispensable. I am too. Perhaps not for my kids and husband but generally, life will go on without me.

It’s a comforting thought…knowing that life will keep moving forward.

It always does. Just as those who left us after the shooting in Orlando. Heartbroken as I am, I also know that no matter how big the grief or loss is, we have no choice but to find our inner strength and keep marching and keep pace with this thing that we are trapped in, the perpetual march of life.

Tomorrows can only be better if todays are valued. With incurable cancer, today is what I have.
And today is what life offers you as well.

We all want a better future, devoid of hatred and bigotry. I do too. I may not be around to see what I plant today, to see it grow and thrive to maturity.

Not working for a better future is the loss of ultimate hope.

Life expects all of us to be hopeful. I am too, in so many different ways.

I wish peace to all as we deal with a national tragedy.

I stand by all oppressed and distressed in this moment of grief.

But I remain hopeful. I remain grateful.

Today I tell my daughter to be fierce, to be who she wants to be, to grow wings, to fly, to refuse limits that others try to put on her, be herself , not mold to what others expect but get others used to what she is capable of.
Live large my little girl.
You are a whole person and being. You weren’t born to follow, you were born to lead. You can do anything you want. Remember that!

They will tell you ” girls don’t do that” , you show them.

Let all those dont’s fuel your strength and aspirations.

Tell them your mom was her own person. She broke the ceilings and walls. Tell them you will do the same.

The world needs strong women. Ready to take on, ready to be proud of being women, ready to be fierce.

Lead the way, my girl, lead the way!

Your path may have obstacles but there is always a way around it.

Your gender is part of who you are not what you are.

Be a girl, Be a mighty girl, Be fierce!

Always!

Love, Mom

Disagreeing with others on Facebook:
1) It is Ok to disagree with someone’s opinion. However it is not OK to directly accuse them of something without understanding their position.
2) Just as your opinion is dear to you, the other person might feel exactly the same way.
3) if you have strong opinions about a topic, voice it on your wall. Be vulnerable enough to say what is on your mind rather than chasing others with your disagreement. Open your self up rather than trolling others.
4) Scrolling away is an option always.
5) Facebook community is huge, Not every post is meant to instigate you personally. You are not that important neither am I.
6) It takes all kinds to make the world.
7) I am here to connect with like minded people not looking to change you.

8) Swearing and inappropriate language reflect who you are not me.

9) There is an unfollow, unfriend and block button. They help greatly with maintaining sanity.
10) There are times, a facebook discussion will help someone understand things from a different perspective, for that you have to be kind and engaging. Relentless harassment is not the way about it.
11) Good ways to end a discussion is bringing Hitler, KKK or ISIS in it. Unless the discussion is about them.
11) There is a person behind that opinion. Try and remember that.
Love social media 🙂

I lay here next to him in his room, and he is cuddled right next to me. His hair smells fresh and nice, and he is telling me something that happened at school today. I am trying to focus on the contents of his story, but my mind is drifting in and out.

It has been barely three days since my diagnosis of Stage 4 metastatic cancer has been confirmed. My 9-year-old boy is lying next to me in his bed, and I am staring at the fan in his room. He gets hot easily and loves to have the fan running on high at night. The chain controls have two planets hanging from them. I am sure he can tell me which ones they are along with their special features. They are spinning fast with the air, much like the thoughts in my head.

I am going in to meet the oncologist tomorrow. Tomorrow, my treatment plan will be determined. I am really hoping that I get to keep my hair, not because that is the most important thing to me, but a hairless mommy is just a bit freaky to the kids. Nothing says cancer more than a bald head. I haven’t told him yet.

He has grown up under the shadow of cancer for the last two and a half years. He has seen me sick and he has seen me bald. I haven’t been able to rack up the courage to tell him that my cancer has returned. I really don’t know how to explain to him that his mother was diagnosed with an incurable illness. How do I actually destroy his innocence myself?

How do you explain to an eight-year-old, the concept of death, dying and an incurable illness?

I wish I had let him have a pet. A fish, a hamster, something small. Something small that had died. So I could tell how he handles grief. Something insignificant in his universe that could help me answer some of my questions. The earth rotates and the planets spin. The glow in the dark planet set hangs from the curtain rod as well. Everything in nature is supposed to stay in its place to keep the balance. But what about me and him? Why must I change his orbit?

My gaze catches the telescope that sits on the chest of drawers consistent with the theme of the room. He has been obsessed with planets and the universe since he was three. An early reader, he would bring these little planet books from the library and we would read those to him over and over again. Later for the longest time, his favorite book was the “Atlas of the Universe” and I would get inundated with the universe factoids that I would nod my head to as he rattled them off and followed me to the bathroom to make sure I understood.

His universe is under threat by something that was seen under the microscope four days ago. Those metastatic cells, gang banging through my body, found a new home in my liver. He could tell that something was wrong when I had my liver biopsy. The next day when he came from school, I was still in my pajamas, a very rare sight. That evening, he commented to his dad, “Mommy looks just like she used to look when she had cancer.”

My heart sank, and a psychiatrist who always knows what to say was speechless. I made lame excuses that it is because I am not in my day clothes and lied through my teeth.

The fan is whirring, and my mind continues to spin. How exactly do I sit down with him and what words should I use?

“Mommy’s cancer came back?”

“Mommy needs to start treatment again?”

“Mommy feels not so well these days?”

20 years of medical practice and dealing with complex issues, seeing death with my own eyes and discussing terminal diagnosis with patients, one would think, I would have some ability to break this to my son. But no, all this mother is capable of is his wiping her tears and hiding her face in his planets comforter.

He said to me, “Mommy I think I have figured out what www means?”

I think is the “whole wide world” or something.

I wipe my tears and say “Very close, it’s the world wide web”

He, then, cuddles some more, the whole wide world shrinks in my arms and he dozes off.

The clock keeps ticking. It’s the shape of an iPad, I found it on Zullily and was very pleased with my purchase. His chess trophies stare at me and the Legos stay still. He is gently breathing in his sleep.

His universe is under threat. I think, “Thank God he has a telescope so he can watch mommy when she becomes a star.” My eyes fill up again.

On the wall there is a decal that I thought would be good for him to look at every day,

“Today you are You, that is truer than true. There is no one alive who is Youer than You.”

Let him sleep one more night with his innocence. There is a lifetime ahead of him to learn about death and dying. I am alive today and that is truer than true.

Goodnight my son!

Goodnight stars!

Goodnight moon!

Goodnight to sons everywhere!